Scientists compared the visual outcomes and associated morbidity of patients with Fuchs’ endothelial corneal dystrophy treated with Descemet’s membrane endothelial keratoplasty or descemetorhexis without endothelial keratoplasty.

The retrospective, comparative cohort study included 27 eyes with mild-to- moderate Fuchs’ dystrophy (with corneal guttae/edema limited to the central cornea with relatively clear periphery) treated at the University of Pittsburgh Medical Center from 2015 to 2017, with either DMEK (n=15) or DWEK (n=12). Descemetorhexis was performed by removing the central 4 mm of diseased Descemet’s membrane at the end of phacoemulsification for cataract surgery. Visual acuity was measured using the Snellen chart and then converted to logMAR for analysis. Some of the scientists’ findings were as follows:

• The average postoperative pinhole VA was 20/25 − 1 (logMAR 0.16 ±0.09) for DMEK eyes and 20/30 + 1 (logMAR 0.13 ±0.10) for DWEK eyes (p=0.44).
• The average time to 20/40 vision for DMEK was 2.2 ±2.8 weeks compared with 7.1 ±2.7 weeks for DWEK (p<0.01).
• In the DMEK group, eight individuals (53 percent) had adverse events, including increased intraocular pressure (n=7), anterior chamber inflammation (n=1), and graft nonadherence (n=1), with one individual requiring anterior chamber paracentesis (6.7 percent) and one person requiring a rebubbling procedure (6.7 percent).
• The DWEK group had no adverse events (p<0.01).

Scientists found that DWEK effectively treated select individuals with mild-to-moderate Fuchs’ dystrophy with equivalent visual outcomes compared with the current standard of care, i.e., DMEK. They wrote that DWEK cases had reduced adverse events and need for additional procedures and didn’t require long-term immunosuppression or donor corneal tissue, although recovery time could be longer.

Researchers wrote that the association between long-term cardioprotective aspirin use and neovascular age-related macular degeneration is controversial. They performed a retrospective, population-based study using a nationwide cohort from clinics and hospitals in South Korea in an effort to estimate the risk of nAMD with long-term regular use of low-dose aspirin.

Researchers identified nonregular aspirin users and regular aspirin users under the country’s national health insurance, age ≥45 years, who were followed from 2010 through 2015. They estimated nAMD incidence per 10,000 person-years. Long-term regular use of low-dose aspirin was defined as sustained intake of ≤100 mg aspirin with ≥1,044 days-prescription between 2005 and 2009. Nonregular aspirin users included occasional users or nonusers. The analyses included: a propensity score-adjusted analysis in a large, randomly selected, unmatched whole cohort (n=482,613); propensity score-matched analysis in a matched cohort (n=74,196); and maximally adjusted analysis in the unmatched whole cohort (n=482,613). Main outcome measures included incidence of newly developed nAMD using the registration code for intractable disease under national health insurance.

The incidence of nAMD was 3.5 among nonregular aspirin users and 7.2 among regular aspirin users, per 10,000 person-years in the unmatched whole cohort. However, propensity score-adjusted analyses revealed no association between aspirin use and nAMD (adjusted HR, 0.98; CI, 0.73 to 1.30). Similarly, propensity score-matched analyses showed no association; incidences of nAMD were 7.5 among nonregular aspirin users and 7.1 among regular aspirin users (crude HR, 0.94; CI, 0.70 to 1.28). A maximally adjusted model—including age, sex, income, residential area and history of 100 randomly selected types of generic drugs— showed no association (adjusted HR, 0.95; CI, 0.71 to 1.28).

Researchers found no association between regular use of low-dose aspirin for five years and future incidence of nAMD. As such, their findings suggested that regular, long-term use of low-dose aspirin appeared to be safe with respect to the new development of nAMD.